PROJECT SUMMARY (ABSTRACT) ! Mycobacterium tuberculosis (M.tb) was responsible for more than 1.6 million deaths in 2017, making it a leading infectious cause of death worldwide. Currently, Mycobacterium bovis bacille Calmette-Gurin (BCG) is the only licensed vaccine for tuberculosis. BCG provides protection against disseminated forms of the disease in children but is inconsistent in preventing the development of pulmonary tuberculosis in adults. Since adults with pulmonary tuberculosis are highly infectious, control of the epidemic will not be achieved with BCG, and new vaccines are urgently needed. A number of lines of evidence from human and animal studies have revealed the critical importance of T cells in conferring protective immunity to M.tb. However, we still do not know which M.tb antigens are targeted by the T cells that confer protection. This information is critical to developing new vaccines that are more effective than BCG. Classically, T cells are activated by foreign peptide antigens that are bound to highly polymorphic major histocompatibility (MHC) molecules. Alternatively, mycobacterial cell wall lipids have conclusively been shown to activate human T cells when bound to CD1 proteins on antigen- presenting cells. The CD1 system has been shown to mediate protective T-cell responses in mouse models of autoimmunity, cancer, and infectious diseases. However, the lack of an appropriate animal model has impeded research into the importance of CD1-restricted T cells in the pathogenesis of M.tb. Tools to identify CD1- restricted T cells were also unavailable until recently. Over the last ten years, we have established lipid-loaded CD1 tetramers as tools to study the phenotypes and functions of CD1-restricted T cells in humans. We have also developed and validated a humanized CD1 transgenic (hCD1Tg) mouse model and shown that T-cells specific for mycolic acid, a major constituent of the mycobacterial cell wall, confer protective immunity to M.tb challenge. Finally, we are now also developing CD1 tetramers for non-human primate (NHP) models of TB. These preliminary data establish the feasibility of developing small and large animal models for studying the role of CD1-restricted T cells in TB pathogenesis. In Aim 1, we will validate a suite of human CD1 tetramers loaded with synthetic lipid antigens and determine the tissue-specific phenotypes and functions of CD1-restricted T cells after mycobacterial vaccination or infection of hCD1Tg mice and NHP. In Aim 2, we will explore whether BCG administered by different routes (cutaneous, aerosol, or intravenous) or primary M.tb infection induces lipid- specific T cells that confer protective immunity to M.tb challenge in hCD1Tg mice and NHP. We will also study whether lipid antigen-specific T cells confer protective immunity using adoptive transfer experiments in hCD1Tg mice. By the end of the funding period, we will have validated a set of tools that will be available to the broader TB research community and addressed whether lipid-specific T cells should be considered a correlate of protective immunity in Phase II/III clinical efficacy studies of whole cell mycobacterial vaccines.